Septal myectomy

Septal myectomy

Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM). Septal myectomies have been successfully performed for more than 25 years.


Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the Mayo Clinic found surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population, and superior to obstructive HCM without operation. The results are shown below:cite journal | author = Ommen S, Maron B, Olivotto I, Maron M, Cecchi F, Betocchi S, Gersh B, Ackerman M, McCully R, Dearani J, Schaff H, Danielson G, Tajik A, Nishimura R | title = Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy | journal = J Am Coll Cardiol | volume = 46 | issue = 3 | pages = 470–6 | year = 2005 | pmid = 16053960 | doi = 10.1016/j.jacc.2005.02.090]

| * Includes 0.8% operative mortality.

Comparison with alcohol ablation

Either alcohol septal ablation or myectomy offers substantial clinical improvement for patients with hypertrophic obstructive cardiomyopathy. One non-randomized comparison suggested that hemodynamic resolution of the obstruction and its sequelae are more complete with myectomy.cite journal | author = Ralph-Edwards A, Woo A, McCrindle B, Shapero J, Schwartz L, Rakowski H, Wigle E, Williams W | title = Hypertrophic obstructive cardiomyopathy: comparison of outcomes after myectomy or alcohol ablation adjusted by propensity score | journal = J Thorac Cardiovasc Surg | volume = 129 | issue = 2 | pages = 351–8 | year = 2005 | pmid = 15678046 | doi = 10.1016/j.jtcvs.2004.08.047] Whether one or the other treatment is preferable for certain patient types is debated among cardiovascular scientists. [cite journal |author=Heldman AW, Wu KC, Abraham TP, Cameron DE |title=Myectomy or alcohol septal ablation surgery and percutaneous intervention go another round |journal=J. Am. Coll. Cardiol. |volume=49 |issue=3 |pages=358–60 |year=2007 |pmid=17239718 |doi=10.1016/j.jacc.2006.10.029 |url=]

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